Use Of Novel Psychoactive Substances Research Articles

Evaluating cross-reactivity of new psychoactive substances (NPS) in human whole blood by enzyme-linked immunosorbent assay (ELISA).

Due to the increase in the use of novel psychoactive substances (NPS) and their overall prevalence, it is important to have effective and reliable screening technologies to detect NPS in biological matrices. Enzyme-linked immunosorbent assays (ELISA) are among the most popular screening methods. To evaluate the effectiveness of ELISA for NPS detection, five subclasses of NPS (novel synthetic opioids, fentanyl analogs, stimulants, benzodiazepines and hallucinogens) were evaluated in whole blood for their cross-reactivity on commercially available ELISA kits. A variety of novel synthetic opioids were tested at concentrations of 1-80 ng/mL and 50-2000 ng/mL and demonstrated no cross-reactivity to a morphine ELISA plate at either concentration range. Fentanyl analogs were tested at concentrations ranging from 0.01 to 1 ng/mL and had cross-reactivities ranging from 8% to 178% on the fentanyl ELISA kit used. Both para-chloro fentanyl (178%) and acryl fentanyl (164%) showed cross-reactivities well above that of fentanyl. Novel stimulants were tested at concentrations of 0.5-40 ng/mL and 20-2,000 ng/mL. 4-Fluoroamphetamine was the only novel stimulant with cross-reactivity (3,354%) to the amphetamine ELISA plate. Novel benzodiazepines were tested at concentrations of 1-40 ng/mL on a benzodiazepine plate. Cross-reactivities ranged from 36.1% to 263%, with desalkylflurazepam having the highest cross-reactivity. Finally, novel hallucinogens were tested at concentrations of 0.5-10 ng/mL on a phencyclidine (PCP) ELISA plate, which produced no cross-reactivity and then with 10-1,000 ng/mL, which gave results from 56.6% to 151%. Both hydroxy-PCP (151%) and chloro-PCP (137%) showed cross-reactivities above that of PCP. This research has demonstrated the utility of using ELISA-based screening for novel benzodiazepines, hallucinogens and for fentanyl analogs; however, there is limited application and risk of false-negative results for the other drug classes due to low or non-existent cross-reactivities.

Monitoring the use of novel psychoactive substances in Australia by wastewater-based epidemiology

Users of novel psychoactive substances (NPS) are at risk, due to limited information about the toxicity and unpredictable effects of these compounds. Wastewater-based epidemiology (WBE) has been used as a tool to provide insight into NPS use at the population level. To understand the preferences and trends of NPS use in Australia, this study involved liquid chromatography mass spectrometry analysis of wastewater collected from Australian states and territories from February 2022 to February 2023. In total, 59 different NPS were included across two complementary analytical methods and covered up to 57 wastewater catchments over the study. The NPS detected in wastewater were 25-B-NBOMe, buphedrone, 1-benzylpiperazine (BZP), 3-chloromethcathinone, N,N-dimethylpentylone (N,N-DMP), N-ethylheptedrone, N-ethylpentylone, eutylone, 4F-phenibut, 2-fluoro deschloroketamine, hydroxetamine, mephedrone, methoxetamine, methylone, mitragynine, pentylone, phenibut, para-methoxyamphetamine (PMA), alpha-pyrrolidinovalerophenone (α-PVP) and valeryl fentanyl. The detection frequency for these NPS ranged from 3 % to 100 % of the sites analysed. A noticeable decreasing trend in eutylone detection frequency and mass loads was observed whilst simultaneously N,N-DMP and pentylone increased over the study period. The emergence of some NPS in wastewater pre-dates other sources of monitoring and provides further evidence that WBE can be used as an additional early warning system for alerting potential NPS use.

Study of metabolism and potential toxicity of nine synthetic opioid analogs using the zebrafish larvae model.

The use of novel psychoactive substances (NPSs) has dramatically increased worldwide, and among them, synthetic opioids are one of the fastest growing groups, where cinnamylpiperazines and 2-benzylbenzimidazoles represent two of the most relevant subclasses. However, the data on their toxicity and metabolism are still limited. The aim of the present study was to evaluate the toxicity and metabolic pathways of some compounds belonging to these families, namely, AP-237, 2-methyl AP-237, isotonitazene, flunitazene, etodesnitazene, metonitazene, metodesnitazene, N-pyrrolidino etonitazene, and butonitazene. The study was performed using a zebrafish early life stages model. In fact, zebrafish (Danio rerio) embryos and larvae have recently been recognized as a suitable animal model in alternative to mammals, because they require less time and resources and do not need complex procedures for ethics approval. The cellular toxicity after a single administration was assessed at the fourth day post-fertilization with acridine orange staining. Possible morphological defects were evaluated with a light microscope after 24 h of exposure to 1μmol/L concentration of each drug. Subsequently, the larvae were euthanized and underwent analysis of drug metabolites using UPLC coupled to an Orbitrap high-resolution mass spectrometer. High rates of morphological defects, as well as of cellular death, were detected, but no significant difference in mortality between treatment and control groups was observed. In addition, several metabolites, mainly produced through monohydroxylation, N-dealkylation, and O-dealkylation, were identified in the larvae extracts.

Methamphetamine-induced lethal toxicity in zebrafish larvae.

The use of novel psychoactive substances has been steadily increasing in recent years. Given the rapid emergence of new substances and their constantly changing chemical structure, it is necessary to develop an efficient and expeditious approach to examine the mechanisms underlying their pharmacological and toxicological effects. Zebrafish (Danio rerio) have become a popular experimental subject for drug screening due to their amenability to high-throughput approaches. In this study, we used methamphetamine (METH) as an exemplary psychoactive substance to investigate its acute toxicity and possible underlying mechanisms in 5-day post-fertilization (5 dpf) zebrafish larvae. Lethality and toxicity of different concentrations of METH were examined in 5-dpf zebrafish larvae using a 96-well plate format. METH induced lethality in zebrafish larvae in a dose-dependent manner, which was associated with initial sympathomimetic activation, followed by cardiotoxicity. This was evidenced by significant heart rate increases at low doses, followed by decreased cardiac function at high doses and later time points. Levels of ammonia in the excreted water were increased but decreased internally. There was also evidence of seizures. Co-administration of the glutamate AMPA receptor antagonist GYKI-52466 and the dopamine D2 receptor antagonist raclopride significantly attenuated METH-induced lethality, suggesting that this lethality may be mediated synergistically or independently by glutamatergic and dopaminergic systems. These experiments provide a baseline for the study of the toxicity of related amphetamine compounds in 5-dpf zebrafish as well as a new high-throughput approach for investigating the toxicities of rapidly emerging new psychoactive substances.

Reports of Adverse Events Associated with Use of Novel Psychoactive Substances, 2017-2020: A Review.

An important role of modern forensic and clinical toxicologists is to monitor the adverse events of novel psychoactive substances (NPS). Following a prior review from 2013 to 2016, this critical literature review analyzes and evaluates published case reports for NPS from January 2017 through December 2020. The primary objective of this study is to assist in the assessment and interpretation of these cases as well as provide references for confirmation methods. Chemistry, pharmacology, adverse events and user profiles (e.g., polypharmacy) for NPS are provided including case history, clinical symptoms, autopsy findings and analytical results. Literature reviews were performed in PubMed and Google Scholar for publications using search terms such as NPS specific names, general terms (e.g., ‘designer drugs’ and ‘novel psychoactive substances’), drug classes (e.g., ‘designer stimulants’) and outcome-based terms (e.g., ‘overdose’ and ‘death’). Government and website drug surveillance databases and abstracts published by professional forensic science organizations were also searched. Toxicological data and detailed case information were extracted, tabulated, analyzed and organized by drug category. Case reports included overdose fatalities (378 cases), clinical treatment and hospitalization (771 cases) and driving under the influence of drugs (170 cases) for a total of 1,319 cases providing details of adverse events associated with NPS. Confirmed adverse events with associated toxidromes of more than 60 NPS were reported including synthetic cannabinoid, NPS stimulant, NPS hallucinogen, NPS benzodiazepine and NPS opioid cases. Fifty of these NPS were reported for the first time in January 2017 through December 2020 as compared to the previous 4 years surveyed. This study provides insight and context of case findings described in the literature and in digital government surveillance databases and websites during a recent 4-year period. This review will increase the awareness of adverse events associated with NPS use to better characterize international emerging drug threats.

Knowledge and Use of Novel Psychoactive Substances in an Italian Sample with Substance Use Disorders.

This study aims to determine prevalence and frequency of use of novel psychoactive substances (NPS) and to identify the factors associated with NPS use in an Italian sample of patients diagnosed with substance use disorder (SUD). Prevalence and correlates of NPS knowledge and use were assessed in 185 patients with SUD in three addiction services (Padova, Belluno, Feltre) in the Veneto region with an ad-hoc designed survey. Two thirds of the samples reported knowing NPS and one third reported using them. NPS were considered by them less dangerous than “regular” substances of abuse (t = 6.06 mean 0.78, p < 0.001). Factors associated with NPS use were youth (OR = 4.81; p < 0.001), studentship (OR = 4.99; p = 0.004), subsequent mental disorders diagnosis (OR = 2.49; p = 0.027), suicide attempt history (OR = 11.67; p < 0.001), home detention (OR = 2.30; p = 0.040), residential care (OR = 5.66; p = 0.002), and polysubstance abuse (t = 8.99 mean 2.65 p < 0.001). NPS use in patients with SUD is highly prevalent, particularly in the youngest age group, and associated with psychiatric comorbidity and worse prognosis. It is crucial to systematically assess NPS use and inform addiction service users with SUD of the toxic and potentially lethal side effects. Mental healthcare professionals working in addiction services should receive education and training. Cohort and longitudinal studies are needed.

Knowledge and Use of Novel Psychoactive Substances in Italy: a Survey-Based Study in the General Population

Knowledge and Use of Novel Psychoactive Substances in Italy: a Survey-Based Study in the General Population

Availability of Illegal Drugs During the COVID-19 Pandemic in Western Germany.

Background: In response to the COVID-19-pandemic, a lockdown was established in the middle of March 2020 by the German Federal Government resulting in drastic reduction of private and professional traveling in and out of Germany with a reduction of social contacts in public areas.Research Questions: We seek evidence on whether the lockdown has led to a reduced availability of illegal drugs and whether subjects with substance-related problems tried to cope with possible drug availability issues by increasingly obtaining drugs via the internet, replacing their preferred illegal drug with novel psychoactive substances, including new synthetic opioids (NSO), and/or by seeking drug treatment.Methods: A questionnaire was anonymously filled in by subjects with substance-related disorders, typically attending low-threshold settings, drug consumption facilities, and inpatient detoxification wards from a range of locations in the Western part of Germany. Participants had to both identify their main drug of abuse and to answer questions regarding its availability, price, quality, and routes of acquisition.Results: Data were obtained from 362 participants. The most frequent main substances of abuse were cannabis (n = 109), heroin (n = 103), and cocaine (n = 75). A minority of participants reported decreased availability (8.4%), increased price (14.4%), or decreased quality (28.3%) of their main drug. About 81% reported no change in their drug consumption due to the COVID-19 pandemic and the lockdown. A shift to the use of novel psychoactive substances including NSO were reported only by single subjects. Only 1–2% of the participants obtained their main drug via the web.Discussion: Present findings may suggest that recent pandemic-related imposed restrictions may have not been able to substantially influence either acquisition or consumption of drugs within the context of polydrug users (including opiates) attending a range of addiction services in Germany.

The potential rewarding and reinforcing effects of the substituted benzofurans 2-EAPB and 5-EAPB in rodents

Accounts regarding the use of novel psychoactive substances continue to escalate annually. These include reports on substituted benzofurans (SBs), such as 1-(1-benzofuran-2-yl)-N-ethylpropan-2-amine (2-EAPB) and 1-(1-benzofuran-5-yl)-N-ethylpropan-2-amine (5-EAPB). Reports on the deaths and adverse consequences from the use of SBs warrant the investigation of their mechanism, possibly predicting the effects of similar compounds. Accordingly, we investigated the possible rewarding and reinforcing effects of 2-EAPB and 5-EAPB through conditioned place preference (CPP), self-administration, and locomotor sensitization tests. We also determined the possible influence of 2-EAPB and 5-EAPB administration on dopamine- and plasticity-related proteins in the nucleus accumbens and ventral tegmental area. 2-EAPB and 5-EAPB induced CPP at different doses and were self-administered by rats. Only 5-EAPB induced locomotor sensitization in mice. 2-EAPB and 5-EAPB did not alter the expressions of dopamine D1 and D2 receptors in the nucleus accumbens, nor changed tyrosine hydroxylase and dopamine transporter expressions in the ventral tegmental area. Both 2-EAPB and 5-EAPB enhanced deltaFosB, but not transcription factor cyclic AMP-response-element binding protein and brain-derived neurotrophic factor in the nucleus accumbens. Hence, the potential rewarding and reinforcing effects on rodents induced by 2-EAPB and 5-EAPB may possibly be associated with alterations in other neurotransmitter systems (besides mesolimbic) and/or neuro-plastic modifications.

The switch from one substance-of-abuse to another: illicit drug substitution behaviors in a sample of high-risk drug users.

BackgroundSubstitution can be defined as the consciously motivated choice to use one drug, either licit or illicit, instead of another, due to perceptions of cost, availability, safety, legality, substance characteristics, and substance attributions. Substitution represents a potential risk to drug users, mainly when substitutes are of higher potency and toxicity. This study offers a basic conceptualization of illicit substitution behavior and describes substitution patterns among users of two highly prevalent drugs of abuse—heroin and cannabis.MethodsHere, 592 high-risk drug users undergoing pharmacological and psycho-social treatment were interviewed. Patients were asked questions about current drug use, lifetime substitution, and substitution patterns. Descriptive statistics, chi-square tests of independence, and multinomial logistic regressions were used to identify and test correlates of substitution patterns for heroin and cannabis.ResultsOf the 592 drug users interviewed, 448 subjects (75.7%) reported having substituted their preferred drug for another illicit substance. Interviews yielded a total of 275 substitution events reported by users of cannabis, and 351 substitution events reported by users of heroin. The most frequently reported substitution substances for responders who preferred heroin were illicit non-prescribed “street” methadone (35.9%), followed by oral and transdermal prescription opioids (17.7%). For responders who preferred cannabis, substitution for synthetic cannabinoid receptor agonists (33.5%) followed by alcohol (16.0%) were the most commonly reported. Age at onset–of–use (p < 0.005), population group (p = 0.008), and attending treatment for the first time (p = 0.026) were significantly associated with reported lifetime substitution. Past-year use of stimulants, heroin, hallucinogens, methylenedioxymethamphetamine (MDMA), and novel psychoactive substances were—at the 95% confidence level—also significantly associated with reported lifetime substitution. In multivariate analysis, the odds for methadone substitution among heroin users were significantly affected by age at onset-of-use, type of treatment center, and education. Odds for substitution for synthetic cannabinoid receptor agonists among cannabis users were significantly affected by age, population group, type of treatment center, and education.ConclusionSelf-substitution behavior should be considered by clinicians and policymakers as a common practice among most drugusers. Substitution for street methadone provides evidence for the ongoing diversion of this substance from Opioid Maintenance Treatment Centers, while the prominence of substitution of synthetic cannabinoids among dual-diagnosis patients should be regarded as an ongoing risk to patients that needs to be addressed by clinicians. Analysis of additional substitution patterns should provide further valuable insights into the behavior of drugusers.

Misuse of prescription medicines is as prevalent as the use of recreational drugs and novel psychoactive substances in Singapore: an unrecognised public health issue?

Misuse of prescription medicines and the harms associated with such use are growing threats across the world. There is currently, however, limited data on the extent of prescription medicine misuse in Singapore and whether this is a current threat in the country. An online survey, limited to 1,000 individuals (aged 21 years and over) who were residents in Singapore, was administered through a survey panel company in September 2015. The survey collected information on participant demographics, and their awareness, self-reported lifetime and past-year misuse of commonly available prescription medicines in Singapore as well as the use of a range of recreational drugs and novel psychoactive substances (NPS). Lifetime (6.7%) and past-year (4.8%) misuse of any prescription medicine was comparable to lifetime (6.0%) and past-year (3.0%) use of any recreational drugs/NPS. The top five prescription medicines for lifetime misuse were: diazepam (2.7%); codeine (2.3%); dhasedyl (promethazine, codeine and ephedrine; 1.6%); panadeine (paracetamol and codeine; 1.5%); and methylphenidate (1.2%). The top five drugs for past-year misuse were: diazepam (1.6%); codeine (0.9%); panadeine (0.7%); alprazolam (0.6%); baclofen (0.6%); and gabapentin (0.6%). Misuse of prescription medicine in Singapore was common, with prevalence comparable to the use of recreational drugs/NPS. A common source for misused drugs was physicians. Further studies are required to determine whether this is more widespread in Singapore and establish the different forms of drug diversion, so that appropriate prevention strategies can be implemented.

Ocfentanil in France: Seven case reports (2016–2018)

Over the last decade, the use of novel psychoactive substances has been increasing dramatically. Among them fentanyl analogs hold a significant place as these “ultra potent” opioids are often associated with heroin or cocaine and are cheaper to produce. Ocfentanil is a potent fentanyl derivative that has already been reported in Europe and has been detected in the hidden market as an adulterant of heroin. The aim of this article is to present an overview of cases involving ocfentanil (OcF) in France over the past three years. The OcF concentrations measured in peripheral blood range from 3.7 to 35.2 μg/L. Among these seven people, three survived despite measured concentrations of ocfentanil were high. The analysis of the powder found near the body (6 cases out of 7) allowed to reveal the presence of OcF and then to looking for it in biological sample using specific technique. Indeed, toxicological comprehensive screenings performed in forensic toxicology using GC-MS or LC-DAD may fail to detect NPS due to a lack of sensitivity.

The effect of repeated-intermittent exposure to 5-methoxy-N,N-diisopropyltryptamine (5-MeO-DIPT) during adolescence on learning and memory in adult rats.

According to the European Drug Report, the use of novel psychoactive substances (NPS) is constantly growing. NPS are widely abused by human adolescent subjects. 5-Methoxy-N,N-diisopropyltryptamine (5-MeO-DIPT) is one of the most frequently used hallucinogenic NPS. 5-MeO-DIPT intoxication results in hallucinations, vomiting, and tachycardia. Long-term exposure to 5-MeO-DIPT was reported to lead to development of post-hallucinogenic perception disorder. The aim of the present study was to determine whether repeated-intermittent administration of 5-MeO-DIPT during adolescence affects learning and memory in adult rats. Rats were treated with 5-MeO-DIPT in a dose of 2.5mg/kg from 30 to 33 and 37 to 40 Postnatal Day (PND). The experiments were conducted when the animals reached 90 PND. The effect of 5-MeO-DIPT on cognitive functions was assessed using the novel object recognition, open field, and serial pattern learning (SPL) tests. Repeated-intermittent exposure to 5-MeO-DIPT during adolescence decreased the number of crossings in the open field test at adulthood. Moreover, 5-MeO-DIPT treatment impaired adult rats' learning in the SPL test. There was no change in the novel object recognition test. The present results show that the performance of adult rats treated with 5-MeO-DIPT during adolescence was impaired in the open field test, which indicates the attenuated exploratory activity. 5-MeO-DIPT treatment undermined adult rats' performance in the serial pattern learning test, suggesting impairment of long term memory and cognitive flexibility. The present study showed that the exposure to 5-MeO-DIPT during adolescence might lead to long-lasting behavioral changes which persisted long after the exposure period.

New drug controls and reduced hospital presentations due to novel psychoactive substances in Edinburgh.

Recreational use of novel psychoactive substance (NPS) has become increasingly common. We aimed to assess the association of national legislation and local trading standards activity with hospital presentations. We established observational cohorts of patients with recreational drug toxicity presenting to Edinburgh Royal Infirmary and dying with detectable recreational drugs in Edinburgh. We assessed associations with two temporary class drug-orders (April 2015: methylphenidates, Nov 2015: methiopropamine), the Psychoactive Substances Act (June 2016), and trading standards forfeiture orders (October 2015). The methylphenidate temporary class drug-order was associated with rapid 46.7% (P=0.002) and 21.0% (P=0.003) reductions in presentations and admissions, respectively, for NPS drug toxicity, comparing 12 months before with 6 months after. The change was greatest for ethylphenidate toxicity (96.7% reduction in admissions, P<0.001) that was partly offset by a tripling in synthetic cannabinoid receptor agonist cases (P<0.001) over the next 6months. This increase reversed following trading standards activity removing all NPS drugs from local shops in October 2015, associated with 64.3% (P<0.001) and 83.7% (P<0.001) reductions in presentations and admissions, respectively, for all NPS drugs over the next 12 months. The effect was sustained and associated with a reduced postmortem detection of stimulant NPS drugs. The two interventions prevented an estimated 557 (95% confidence interval 327-934) NPS admissions during 2016, saving an estimated £303 030 (£177 901-508 133) in hospital costs. We show here that drug legislation and trading standards activity may be associated with effective and sustained prevention. Widespread adoption of trading standards enforcement, together with focused legislation, may turn the tide against these highly-damaging drugs.

Synthetic and Non-synthetic Cannabinoid Drugs and Their Adverse Effects-A Review From Public Health Prospective.

There is a growing use of novel psychoactive substances containing synthetic cannabinoids. Synthetic cannabinoid products have effects similar to those of natural cannabis, yet, these drugs are more potent and dangerous, and have been associated with dangerous adverse effects. Here, we review current literature on the epidemiology, acute, and chronic effects of synthetic and natural cannabinoid-based drugs. Synthetic drugs contain a mixture of psychoactive compounds that mostly bind cannabinoid receptors with high potency. These synthetic drugs replicate the effects of natural cannabis and Δ9-tetrahydrocannabinol but they induce more severe adverse effects including respiratory difficulties, hypertension, tachycardia, chest pain, muscle twitches, acute renal failure, anxiety, agitation, psychosis, suicidal ideation, and cognitive impairment. Chronic use of synthetic cannabinoids has been associated with serious psychiatric and medical conditions and even death. Given the growing popularity in the use of cannabinoid-based drugs and their harmful potential, there is a need for further research in this field.

Multilevel population-based cross-sectional study examining school substance-misuse policy and the use of cannabis, mephedrone and novel psychoactive substances among students aged 11–16 years in schools in Wales

ObjectivesTo examine whether young peoples’ risk of cannabis, mephedrone and novel psychoactive substances (NPS) use is associated with school substance-misuse policy.DesignA cross-sectional survey of secondary school students combined with a...

Benzofuran Analogs of Amphetamine, Emerging Novel Psychoactive Substances in Colombia: A Narrative Review

The use of novel psychoactive substances (NPS) is a growing phenomenon worldwide that harms user’s health and increases healthcare system costs. In September 2017, amphetamine-analog benzofurans (APB) were reported by the Sistema de Alertas Tempranas, a brach of Observatorio de Drogas de Colombia. At first, benzofurans use was globally reported as an adulterant of other psychoactive substances but, due its legal status, its easy commercialization and because of government and doctors did not know those substances; they have noticeably been growing as a drug of choice. In the face of this new threat, this review tries to expose information expecting it will help in these needs. A wide bibliographical review was made regarding pharmacodynamic and pharmacokinetic characteristics, clinical effects and toxicity, and marketing strategies about 4-APB, 5-APB and 6-APB.

Systematic analysis of novel psychoactive substances. I. Development of a compound database and HRMS spectral library

With the rise in illicit use of novel psychoactive substances (NPS), there is a need to comprehensively screen for drugs in this class. In the present project to explore the screening potential of high resolution mass spectrometry (HRMS) for NPS, liquid chromatography quadrupole time of flight mass spectrometry (LC-QTOF-MS) was utilized to generate a tandem mass spectrometry (MS/MS) spectral library in positive electrospray ionization mode. The library contains data for 252 NPS from multiple classes, including cathinones, piperazines, tryptamines, and synthetic cannabinoids. Spectra were collected by flow injection analysis under standardized conditions at three different collision energies (10, 20, and 40 eV) for each compound. In addition to the spectral library, a compound database was created to further enhance the screening potential of the LC-QTOF-MS. This database contains chemical and structural information for 875 NPS compounds and metabolites that can be used to help aid the identification of unknowns in a full mass scan. To demonstrate the applicability of the HRMS library, 13 serum samples were spiked with NPS from various structural classes with up to five different NPS per sample, and four authentic seized drug case samples, were analyzed. The HRMS library search successfully identified 32 of the 35 compounds present in the spiked serum samples. In addition, HRMS-based screening of seized samples provided results consistent with the official forensic laboratory findings. The combination of a HRMS spectral library, compound database, and accurate mass LC-QTOF-MS analysis represents a useful tool for the identification of NPS in forensic screening applications.

The Experience and Meaning of Problematic ‘G’ (GHB/GBL) Use in an Irish Context: an Interpretative Phenomenological Analysis

The problematic use of psychoactive substances has adverse consequences for people’s lives and requires on-going investigation of experiences of onset, course and resolution in order to better inform theoretical understanding, particularly with regard to the use of club drugs and novel psychoactive substances. In turn, this may influence treatment approaches. GHB/GBL, frequently termed ‘G’, is one such substance, with problematic use resulting in increased presentations at AE (2) daily use: “It’s like insidious; it just weaves into your everyday life”; and (3) early recovery: “my priorities are changing”. This study supports the interactive role of community, self-identity, personal vulnerability and substance effects in the development, maintenance and recovery from problematic G use. Findings are discussed in the context of gay community health, the role of chemsex in problematic substance use and the need for public health providers to engage with novel psychoactive substance use and the health and well-being effects of chemsex.

Knowledge and (Ab)Use in Connection with Novel Psychoactive Substances: A Cross-Sectional Analysis of Psychedelic Users Existing on Online Platforms

BACKGROUND: The prevalence of use and misuse of novel psychoactive substances (NPS) has been escalating at an exponential rate in the past two decades. Studies on NPS are highly concentrated in relevance to the developed world, while few have been undertaken in the developing countries.MATERIALS &amp; METHODS: This study is observational and cross-sectional in nature; it relies on a web-based survey distributed to a population of (ab)users of psychedelics and NPS; this community was accessible via dedicated online platforms psychedelics users located on the Facebook social communication medium. The aim of the study is to estimate the level of knowledge and the extent of (mis)use in connection with psychoactive substances, including the novel ones (NPS).RESULTS: The number of participants who responded to the survey reached 458 responders. The level of knowledge and (ab)use was relatively high. The majority of participating individuals were Caucasians males from the developed world including the US, the UK, India, and western European countries. The primary religious affiliation was either agnosticism or atheism. Approximately, 26% were diagnosed with the neuropsychiatric condition.CONCLUSION: The NPS phenomenon is still a major concern primarily in the developed world. Additional studies are required in virtual and non-virtual populations. The targeted populations should include; students, medical professionals, academics, patients with psychiatric and neurological abnormalities, convicts and criminals, and even terrorists.